Psychosocial Stress at Work and Rheumatoid Arthritis

However, research on the relationship between psychosocial work stress and immunological parameters also suggests a possible association with inflammatory conditions, including rheumatoid arthritis (RA).

In order to investigate whether high psychological job demands, low decision latitude and job strain are associated with the risk of developing RA, a group of Swedish investigators used data from EIRA, a large population-based case-control study with incident cases of RA.

Psychological job demands and job decision latitude were measured according to questions developed by Karasek and Theorell. Questions were posed about participants’ present work situations; both demands and decision latitude were categorized using the quartiles among the controls (each gender separately) as cut-off points. High psychological job demands, as well as high decision latitude, were defined as a score above the upper quartile. Low psychological job demands, as well as low decision latitude, were defined as a score below the lower quartile. Job strain was defined as the combination of high demands and low decision latitude.

The investigators also performed a classification of psychological job demands and decision latitude based on a job exposure matrix (JEM), in order to avoid potential bias due to differential recall between cases and controls. Among the controls, mean scores of demands and decision latitude were calculated for each latest reported occupation (each gender separately) where the number of controls was at least 3. Both cases and controls were then given the mean scores according to their latest reported occupation.

To summarize few methodological considerations, the investigators conclude that the observed association between low decision latitude and risk of developing RA is most likely real, and that the influence of various biases is of limited magnitude. The main new finding of this study was that low decision latitude was associated with an increased risk of developing RA, according to both self-reported and JEM-derived information. Low decision latitude is also the component in the demand-control model that has most consistently been related to risk of cardiovascular disease. Furthermore, some evidence that those with high psychological job demands had a decreased risk of RA was found.

REHACARE.de; Source: Journal of Psychotherapy and Psychosomatics

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